Abstract Background/Aims Axial spondyloarthritis (axSpA) is often diagnosed late, with UK patients waiting an average of 8.5 years from symptom onset to diagnosis. This delay, alongside inconsistent access to specialist pathways, highlights the need for coordinated service development. The Pan-London Axial SpA Network (PLAN) was established in 2024 to support collaboration between centres and to identify gaps in provision. This survey aimed to capture current service structures across London and highlight opportunities for improvement. Methods An online questionnaire was circulated in May 2025 to rheumatology consultants, trainees and physiotherapists working across various hospitals in London. The survey covered clinic organisation, referral and diagnostic pathways, patient information and access to allied services including physiotherapy, imaging, and psychology. Responses were collated and summarised descriptively. Results Responses were received from 16 rheumatology services. Nine centres (56%) reported running a dedicated axSpA clinic, most with some multidisciplinary input. Median referral-to-diagnosis time was 3-4 months (range 1-12 months). Only four centres (25%) reported established axSpA education programmes within their primary care services. All centres supplied written information about axSpA at diagnosis for patients; most also provided verbal counselling (88%) and a telephone helpline (81%). Structured self-management sessions were available in half of centres (50%). Care plans were issued by 14 services (88%), though only 6 (38%) contained specific guidance for managing flares. MRI was predominantly reported by consultant musculoskeletal radiologists in most centres (94%). Only 50% of centres ran combined clinics with other specialties such as gastroenterology or dermatology. Physiotherapy access was reported by 15 centres (94%), but the proportion of new patients routinely referred varied considerably, from fewer than 20% to more than 80%. Dedicated psychological support was available in just four centres (25%). When asked about priorities and goals for the PLAN network, the most common responses were the development of best practice pathways (81%), shared research projects (69%) and joint case discussions for complex patients (63%). Conclusion This London-wide survey demonstrates clear variation in the organisation of axSpA services. While access to imaging and physiotherapy is generally high, there are notable shortfalls in psychological support, primary care education and joint working with other specialties. The variation in referral practices and the absence of dedicated clinics in many centres highlight the need for greater consistency. The findings will guide PLAN’s next steps, focusing on pathway development, collaborative research and case-based learning to improve standards across the region. By working collectively, services can reduce inequity, shorten diagnostic delays and deliver more holistic care for people living with axSpA. Disclosure R. Amarnani: None. S. Bamford: None. A. Chan: None. P.M. Machado: None. E. Nikiphorou: None. N. Wilson: None. H. Tahir: None.
Amarnani et al. (Wed,) studied this question.